Rural tele-risk assessment and GP liaison — CASC/communication station

Station brief

Format. Combined clinical advice and team communication station, approximately 8–10 minutes. Work with the GP/nurse as colleagues; do not monologue guidelines. [1][3]

Candidate instructions. Establish tele-safety (location, contacts, privacy); structure suicide risk including means; advise on immediate ED management and whether transfer is needed; propose short-term collaborative follow-up if remaining local is safe; use non-stigmatising language that fits a farming community. [1][4][5]

Candidate scenario

Setting. Rural ED cubicle; shotgun stored unlocked on the property; partner willing to stay; patient breathalyser low now but chronic heavy use; no prior psychiatric admissions; PHQ-9 high when administered by nurse; patient fears "everyone in town will know" if admitted regionally. [4][5][6]

Marking domains

1. Tele process safety — identity, address, emergency pathway, call-drop plan. [1]
2. Risk formulation — intent, plan, means, alcohol, drought/finance stressors, protective factors (partner). [4][5]
3. Immediate management — environmental safety, means restriction plan, observation level, medical clearance, alcohol withdrawal assessment. [1]
4. Disposition — clear criteria for local management vs involuntary/voluntary transfer; legal language appropriate to jurisdiction. [3]
5. Collaborative care — GP ownership, early review, tele follow-up, crisis contacts; not "see you next year." [3]
6. Communication — respectful, anti-stigma, privacy-aware small-town language. [6]

Model approach

Examiner notes

Pass candidates treat telehealth as a protocolised clinical environment, not a casual phone call; they name means restriction and dual small-town privacy fears; they avoid false choice between "beds only" and "ignore risk." Fail candidates skip location confirmation, ignore the shotgun, use stigmatising language, or discharge without a named review. [1][4][5]